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Review
. 2022 Aug;6(Suppl 5):e009395.
doi: 10.1136/bmjgh-2022-009395.

Optimising the reach of mobile health messaging programmes: an analysis of system generated data for the Kilkari programme across 13 states in India

Diwakar Mohan  1 , Jean Juste Harrisson Bashingwa  2   3   4 , Kerry Scott  5 , Salil Arora  6 , Sai Rahul  7 , Nicola Mulder  4 , Sara Chamberlain  8   9 , Amnesty Elizabeth LeFevre  5   10 ; Kilkari Impact Evaluation Team
Collaborators, Affiliations
Review

Optimising the reach of mobile health messaging programmes: an analysis of system generated data for the Kilkari programme across 13 states in India

Diwakar Mohan et al. BMJ Glob Health. 2022 Aug.

Abstract

Kilkari is an outbound service that makes weekly, stage-based, prerecorded calls about reproductive, maternal, neonatal and child health directly to families' mobile phones, starting from the second trimester of pregnancy and until the child is 1 year old. Since its initiation in 2012-2013, Kilkari has scaled to 13 states across India. In this analysis article, we explored the subscriber's journey from entry to programme to engagement with calls. Data sources included call data records and household survey data from the 2015 National Family Health Survey. In 2018, of the 13.6 million records received by MOTECH, the technology platform that powers Kilkari, 9.5 million (~70%) were rejected and 4.1 million new subscribers were created. Overall, 21% of pregnant women across 13 states were covered by the programme in 2018, with West Bengal and Himachal Pradesh reaching a coverage of over 50%. Among new subscriptions in 2018, 63% were subscribed during pregnancy and 37% after childbirth. Of these, over 80% were ever reached by Kilkari calls and 39% retained in the programme. The main causes for deactivation of subscribers from the system were low listenership and calls going unanswered for six continuous weeks. Globally, Kilkari is the largest maternal mobile messaging programme of its kind in terms of number of subscribers but the coverage among pregnant women remains low. While call reach appears to be on the higher side, subscriber retention is low; this highlights broader challenges with providing mobile health services at scale across India.

Keywords: Health services research; Maternal health; Prevention strategies.

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Conflict of interest statement

Competing interests: SC and SA are employed by BBC Media Action and SR is employed by Beehyv; two of the entities supporting programme implementation. The authors do not have other relationships and are not engaged in activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1
Framework conceptualising eligibility, reach and retention in the Kilkari programme.
Figure 2
Figure 2
Percentage of pregnant women (modelled) with a record in the Kilkari database for 2018.
Figure 3
Figure 3
Timing of subscriptions in the Kilkari programme in 2018 based on the stage of pregnancy for selected states. Black bars denote the proportion of subscribers registered during the second or third trimester of pregnancy. White bars denote the proportion of subscribed 0–6 months post partum and blue bars 6–12 months post partum.
Figure 4
Figure 4
Percentage of subscriptions in the Kilkari programme who answered a call at least once across states.
Figure 5
Figure 5
Reasons for the deactivation of subscribers from the Kilkari programme in 2018.
See this image and copyright information in PMC

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